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General NPI Number Information
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NPI Number | 1912502709
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Entity Type | Organization
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Legal Business Name | GREAT LIFE COUNSELING CENTER, PLLC
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 3465 NATIONAL DR.
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City | PLANO
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State | TX
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Zip | 75025
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Country | US
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Telephone | 469-665-9445
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Fax |
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Provider Business Mailing Address
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Address Line | 3465 NATIONAL DR STE 215
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City | PLANO
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State | TX
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Zip | 75025-1095
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Country | US
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Telephone | 972-987-5460
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Fax |
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Authorized Official
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Title or Position | CEO/LICENSED PSYCHOLOGIST
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Name | DR. KEVIN C. LAMBERT
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Credential | PSY.D.
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Telephone | 469-665-9445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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